Saturday, October 19, 2013


We have just started construction on our new office building.
The location is 4601 Heritage Trace. This is located next to the Bluffs - Northeast of the Beach and Heritage Trace intersection.

We are excited to build and look forward to expanding into a new, larger, state of the art ENT office.
More updates to follow and thank you to all patients for understanding the ongoing construction around our current office and the surrounding communities. Keller and North Fort Worth are expanding quickly!

Monday, December 19, 2011

Nosebleeds in North Texas: notes on Epistaxis from the Texas ENT Center BLOG

   With the cold and dry winter weather now in North Texas, we see a higher incidence of spontaneous nose bleeds as a result of nasal mucosa drying out and cracking.  Heater use is common during December thru February and it further dries the air we breathe indoors.  In this blog post, we want to help remind folks on how to avoid nose bleeds this winter.

Tips to avoid nose bleeds:
1. Keep heater thermostat at 68 degrees or lower.
     (higher temperatures cause more dryness)
2. Use a humidifier
     (ie. in your office or bedroom)
3. Apply a moisturizing agent to your nasal mucosa
     * Options include saline gel (quickly evaporates) and vaseline (difficult to apply),
         so I often recommend topical antibiotic ointment as a good compromise.

Medications and medical conditions that can cause more serious nose bleeds:
   Many medications cause the blood to thin, either as a therapeutic agent or as
   an incidental side effect.  These can dramatically increase the severity of a
   simple nose bleed.
   * Coumadin (Warfarin), Plavix and Aspirin are commonly prescribed blood thinners.
   * Vitamin E, Ginko, and garlic tablets can thin the blood to a lesser degree.
   * High blood pressure

How do you stop a typical nosebleed?
1. Pinch the nostrils (soft parts of your nose) together and compress them firmly into
    your face, hold in place for at least 10 minutes.  Repeat if necessary.
2. You can also use Afrin or Neo-Sinephrine nasal spray prior to the above maneuver,
    which will assist in constricting the bleeding vessels.
     (If used for more then 3 days at a time, Afrin or Neo-Sinephrine can cause addiction with
     severe rebound nasal congestion.  Thus, avoid using these sprays long-term)
3. If you nose bleed is to severe and rapid, or if this this maneuver fails on the second
     or third attempt, then contact your physician or visit the emergency room.
For more information on nosebleeds, click here.

Thursday, November 3, 2011

Pediatric ENT: Obstructive Sleep Apnea

Sleep Apnea in Kids?
   Most of us may consider Obstructive Sleep Apnea, or "OSA", as a problem in the purview of adults who may have excessive tissue in the mouth/throat.  However OSA can also occur in young children, though the cause is often very different: excessively enlarged tonsils and/or adenoids are most often the culprit.

Common Symptoms in children:
   Excessive daytime sleepiness
   Non-restorative sleep (feels tired despite sleeping "enough")
   Loud or raspy snoring
   Gasping or choking during sleep
   Difficulty concentrating
   Irregular breathing during sleep (long pauses between breaths)

Long-term Sequelae:
   Because breathing (and thus oxygen) is obstructed in OSA, there is long term risk for heart and lung problems if OSA is left untreated.  The stress of oxygen deprivation at night stresses the heart and lungs, leading to spikes of high blood pressure and episodes of low blood oxygenation.  Early symptoms are noted above.  Long term, OSA can lead to daytime high blood pressure, overall heart failure, and lung disease (pulmonary hypertension).

How can Pediatric Sleep Apnea treated?
   Since the major cause of OSA in young children is excessively enlarged tonsils and/or adenoids, the treatment is often removal of the tonsils and/or adenoids.  Your physician may recommend a trial of nasal steroids, as this may prevent or delay the need for surgery.
   Some children, with more severe OSA, may require a C-PAP machine.  This is a simple machine which helps keep the airway open during sleep, ameliorating the health risks associated with OSA.

Since every child is unique and since OSA can vary in severity (mild to severe), consult your physician if you suspect your child may have sleep apnea.

At the Texas ENT Center, our practice is carefully designed to care for you and your family. Our youngest patients, infants and toddlers, always receive special care and attention.  As a board-certified otolaryngologist and a father of two, Dr. White has a special interest in sleep apnea as well as pediatric ENT care.

For more info from the American Academy of Otolaryngology, click here. 

Monday, October 24, 2011

Beautiful fall weather in Texas....Welcome to Flu Season 2011

When the weather turns cool and crisp, I look forward to upcoming holiday season.  And I also begin recommending the flu vaccine.

Flu season typically starts quietly in October, gains momentum over the holidays, peaks in December-Janurary, and can linger on through May.   Like the common cold, the flu is a viral infection: flu hits fast and symptoms include fever, cough, sore throat, runny/stuffy nose, body aches, and fatigue.  Some people will have a mild illness, sometimes even without fever!  But sometimes flu can cause severe and life-threatening illness.

The seasonal Flu Vaccine is valuable protection from influenza, preventing illness or at least ameliorating symptom severity.  Here are some Key Points regarding flu vaccine:

   * Your protective antibodies will develop 2 weeks after vaccination, reaching high levels at 4         
       Getting your flu vaccine early in the season (ie. October) will ensure strong antibody levels
       during the peak months.
       But even getting the shot late in the year is helpful, since flu can last
       as late as May.
   * You will not "get the flu" from the vaccine, this is true even with the nasal-spray vaccine.

   * 3 types of vaccine:
          Regular flu shot approved for 6 mo and older.
          Nasal-spray flu vaccine (weakened, live virus) for 2 years - 49 years old.
          High-dose flu shot approved for people 65 years and older.

   * Caution: you should not be vaccinated if you have a severe allergy to chicken eggs or
         a history of Guillain-Barre Syndrome.

Of course, good habits also protect you and prevent spreading flu:
   * Wash your hands frequently!  Embrace hand sanitizers or sanitizing wipes!
   * Cover your cough!

For more information, click here.

Sunday, October 9, 2011

Adele: Vocal Cord Hemorrhage, cancels U.S. tour

British phenom, Adele, recently announced that persistent problems with vocal cord hemorrhage has forced the cancellation of her U.S. tour.   Hoarseness and other voice disorders can be a huge problem for all of us, not only those who are professional singers.

Here are a few tips for how to care for your voice:

1. Avoid overuse.  Try to speak in low to moderate volumes.  Avoid screaming and avoid whispering -- both strain your vocal cords.  If you must speak for many hours a day, then try to rest your voice for 10 minutes every few hours -- this will help preserve your voice over the long term.

2. Hydration.  Ample water intake is extremely important for your voice!  You can always tell if your body is adequately hydrated: your urine will be pale and clear.  Hydration helps maintain the lubricating mucus on your vocal cords.  Dehydrating drinks tend to cause dehydration, so try to avoid these (ie. coffee, soft drinks, energy drinks).  Use a humidifier if needed.

3. Avoid throat clearing: it is traumatic to the vocal cords, leading to excessive strain.  Sometimes throat clearing is a sign of gatroesophageal reflux (GERD) and your physician can help treat this condition.  While most folks with GERD experience "heartburn", many people do not experience this and their only sign of GERD is excessive throat clearing.  

4. Antihistamines/Decongestants: these commonly used medications are often found in cold or allergy treatments.  They often cause dryness to the vocal cords, which brings us back to tip #2.

5. Avoid smoking or second-hand smoke.  Smoking can cause chronic laryngitis/hoarseness, vocal cord polyps, and even cancer of the throat or vocal cords.    If you are a smoker, this is yet another reason to consider smoking cessation if you are a smoker -- please see your health care provider for help on smoking cessation.

If you have any voice concerns, please call Dr. White for an appointment at the Texas ENT Center.
Dr. White has a special interest in voice disorders, and he will develop a treatment plan designed for your voice needs.  For further information on voice hygiene and vocal cord services, please click here.

Click here for a link to the Texas ENT Center in Keller, Texas.

ENT care comes to Keller!

Head and Neck Surgeon brings personalized ENT care to the Keller, north Fort Worth, Roanoke, and surrounding areas.  Dr. Stephen White is proud to live and work in Keller -- and he has a special interest in pediatric otolaryngology, allergy, voice disorders, thyroid surgery, sinusitis, and hearing disorders.  

What is allergic rhinitis?

Allergic rhinitis, often called allergies or hay fever, occurs when your immune system overreacts to particles in the air that you breathe—you are allergic to them. Your immune system attacks the particles in your body, causing symptoms such as sneezing and a runny nose. The particles are called allergens, which simply means they can cause an allergic reaction.

People with allergies usually have symptoms for many years. You may have symptoms often during the year, or just at certain times. You also may get other problems such assinusitis and ear infections as a result of your 

For more details, go here.